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Corporations in biomedicine hold significant power and influence, in both political and personal spheres. The decisions these companies make about ethics are critically important, as they help determine what products are developed, how they are developed, how they are promoted, and potentially even how they are regulated. In the last

Corporations in biomedicine hold significant power and influence, in both political and personal spheres. The decisions these companies make about ethics are critically important, as they help determine what products are developed, how they are developed, how they are promoted, and potentially even how they are regulated. In the last fifteen years, for-profit private companies have been assembling bioethics committees to help resolve dilemmas that require informed deliberation about ethical, legal, scientific, and economic considerations. Private sector bioethics committees represent an important innovation in the governance of emerging technologies, with corporations taking a lead role in deciding what is ethically appropriate or problematic. And yet, we know very little about these committees, including their structures, memberships, mandates, authority, and impact. Drawing on an extensive literature review and qualitative analysis of semi-structured interviews with executives, scientists and board members, this dissertation provides an in-depth analysis of the Ethics and Public Policy Board at SmithKline Beecham, the Ethics Advisory Board at Advanced Cell Technology, and the Bioethics Committee at Eli Lilly and offers insights about how ideas of bioethics and governance are currently imagined and enacted within corporations. The SmithKline Beecham board was the first private sector bioethics committee; its mandate was to explore, in a comprehensive and balanced analysis, the ethics of macro trends in science and technology. The Advanced Cell Technology board was created to be like a watchdog for the company, to prevent them from making major errors. The Eli Lilly board is different than the others in that it is made up mostly of internal employees and does research ethics consultations within the company. These private sector bioethics committees evaluate and construct new boundaries between their private interests and the public values they claim to promote. Findings from this dissertation show that criticisms of private sector bioethics that focus narrowly on financial conflicts of interest and a lack of transparency obscure analysis of the ideas about governance (about expertise, credibility and authority) that emerge from these structures and hamper serious debate about the possible impacts of moving ethical deliberation from the public to the private sector.
ContributorsBrian, Jennifer (Author) / Robert, Jason S (Thesis advisor) / Maienschein, Jane (Committee member) / Hurlbut, James B (Committee member) / Sarewitz, Daniel (Committee member) / Brown, Mark B. (Committee member) / Moreno, Jonathan D. (Committee member) / Arizona State University (Publisher)
Created2012
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Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their

Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century.
ContributorsNunez-Eddy, Claudia (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / O'Neil, Erica (Committee member) / Arizona State University (Publisher)
Created2018
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Influenza has shown its potential to affect and even kill millions of people within an extremely short time frame, yet studies and surveys show that the general public is not well educated about the facts about influenza, including prevention and treatment. For this reason, public perception of influenza is extremely

Influenza has shown its potential to affect and even kill millions of people within an extremely short time frame, yet studies and surveys show that the general public is not well educated about the facts about influenza, including prevention and treatment. For this reason, public perception of influenza is extremely skewed, with people generally not taking the disease as seriously as they should given its severity. To investigate the inconsistencies between action and awareness of best available knowledge regarding influenza, this study conducted literature review and a survey of university students about their knowledge, perceptions, and action taken in relationship to influenza. Due to their dense living quarters, constant daily interactions, and mindset that they are "immune" to fairly common diseases like influenza, university students are a representative sample of urban populations. According to the World Health Organization (WHO), 54% of the world's population lived in cities as of 2014 (Urban population growth). Between 2015 and 2020, the global urban population is expected to grow 1.84% per year, 1.63% between 2020 and 2025, and 1.44% between 2025 and 2030 (Urban population growth). Similar projections estimate that by 2017, an overwhelming majority of the world's population, even in less developed countries, will be living in cities (Urban population growth). Results of this study suggest possible reasons for the large gap between best available knowledge and the perceptions and actions of individuals on the other hand. This may lead to better-oriented influenza education initiatives, more effective prevention and treatment plans, and generally raise excitement and awareness surrounding public health and scientific communication.
ContributorsGur-Arie, Rachel Ellen Haviva (Author) / Maienschein, Jane (Thesis director) / Laubichler, Manfred (Committee member) / Creath, Richard (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-12
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Joseph Rotblat (1908-2005) was the only physicist to leave the Manhattan Project for moral reasons before its completion. He would spend the rest of his life advocating for nuclear disarmament. His activities for disarmament resulted in the formation, in 1957, of the Pugwash conferences, which emerged as the leading global

Joseph Rotblat (1908-2005) was the only physicist to leave the Manhattan Project for moral reasons before its completion. He would spend the rest of his life advocating for nuclear disarmament. His activities for disarmament resulted in the formation, in 1957, of the Pugwash conferences, which emerged as the leading global forum to advance limits on nuclear weapons during the Cold War. Rotblat's efforts, and the activities of Pugwash, resulted in both being awarded the Nobel Peace Prize in 1995. Rotblat is a central figure in the global history of resistance to the spread of nuclear weapons. He also was an important figure in the emergence, after World War II, of a counter-movement to introduce new social justifications for scientific research and new models for ethics and professionalism among scientists. Rotblat embodies the power of the individual scientist to say "no" and thus, at least individually, put limits of conscience on his or her scientific activity. This paper explores the political and ethical choices scientists make as part of their effort to behave responsibly and to influence the outcomes of their work. By analyzing three phases of Rotblat's life, I demonstrate how he pursued his ideal of beneficial science, or science that appears to benefit humanity. The three phases are: (1) his decision to leave the Manhattan Project in 1944, (2) his role in the creation of Pugwash in 1957 and his role in the rise of the organization into international prominence and (3) his winning the Nobel Peace Prize in 1995. These three phases of Rotblat's life provide a singular window of the history of nuclear weapons and the international movement for scientific responsibility in the 50 years since the bombing of Hiroshima in 1945. While this paper does not provide a complete picture of Rotblat's life and times, I argue that his experiences shed important light on the difficult question of the individual responsibility of scientists.
ContributorsEvans, Alison Dawn (Author) / Zachary, Gregg (Thesis director) / Hurlbut, Ben (Committee member) / Francis, Sybil (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor)
Created2015-05
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This thesis aims to address the ethics of keeping the big cats, such as lions, tigers, and leopards, in zoos. It is a practice that has generated some controversy in light of scientific studies reporting stress among wide-ranging animals in captive enclosures, as well as in the context of wider

This thesis aims to address the ethics of keeping the big cats, such as lions, tigers, and leopards, in zoos. It is a practice that has generated some controversy in light of scientific studies reporting stress among wide-ranging animals in captive enclosures, as well as in the context of wider discussions in animal welfare and conservation ethics in zoos. A driving question for this project, therefore, was "What are the arguments for and against keeping large felids in zoos/captivity?" This thesis examines the historical and current ethical approaches to evaluating the ethics of maintaining big cats in zoos. Due to many of the big cat species listed as endangered species on the IUCN redlist, the species-centered approach to zoo ethics is becoming the common viewpoint, and, as a result, zoos are deemed ethical because of their contribution to ex situ conservation practices. Further, the ethical arguments against zoos are minimized when the zoos provide suitable and appropriate enclosures for their large felids. Of course, not all zoos are created equal; the ethics of zoos need to be evaluated on a case-by-case basis, but in general, it is ethical to maintain big cats in zoos.
ContributorsZeien, Krista Marie (Author) / Minteer, Ben (Thesis director) / Smith, Andrew (Committee member) / Ellison, Karin (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / School of Life Sciences (Contributor)
Created2014-05
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The prospect of anti-aging or life extension technology is controversial in biogerentology but deemed even by skeptical experts to warrant discussion. I discuss the justifications that the probability of life extension technology being developed in the near future is reasonably high and that this research justifies the time and money

The prospect of anti-aging or life extension technology is controversial in biogerentology but deemed even by skeptical experts to warrant discussion. I discuss the justifications that the probability of life extension technology being developed in the near future is reasonably high and that this research justifies the time and money it receives. I investigate potential ethical and societal issues anti-aging technology might create. This paper addresses inequality of access, economic cost, changes in quality of life, the role of death in human life, if and how the technology should be regulated and how parties who choose not to undergo treatment can be fairly treated, even when they are a minority.
Created2015-05
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Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent exposure to high-risk patients like: those with compromised immune systems,

Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent exposure to high-risk patients like: those with compromised immune systems, children, and the elderly (Johnson & Talbot, 2011). Though vaccination is vital in disease prevention, influenza vaccination uptake among HCP is low overall (50% on average) (Pearson et al., 2006). Mandatory vaccination policies result in HCP influenza vaccination uptake rates substantially higher than opt-in influenza vaccination campaigns (90% vs. 60%). Therefore, influenza vaccination should be mandatory for HCP in order to best prevent influenza infection in healthcare settings. Many HCP cite individual objections to influenza vaccination rooted in personal doubts and ethical concerns, not best available scientific evidence. Nevertheless, HCP ethical responsibility to their patients and work environments to prevent and lower influenza infection incidence overrules such individual objections. Additionally, mandatory HCP influenza vaccination policies respect HCP autonomy via including medical and religious exemption clauses. While vaccination as a prevention method for influenza is logically sound, individuals’ actions are not always rooted in logic. Therefore, I analyze HCP perceptions and actions toward influenza vaccination in an effort to better explain low HCP uptake rates of the influenza vaccine and individual objections to influenza vaccination. Such analysis can aid in gaining HCP trust when implementing mandatory HCP influenza vaccination policies. In summary, mandatory HCP influenza vaccination policies are ethically justified, effective, scientifically-supported method of maximizing HCP influenza vaccine uptake and minimizing the spread of the influenza virus within healthcare settlings.
ContributorsGur-Arie, Rachel (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, Ben (Thesis advisor) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2016
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American Indian literature is replete with language that refers to broken or hollow promises the US government has made to American Indians, one of the most prominent being that the US government has not kept its promises regarding health services for American Indians/Alaska Natives (AI/AN). Some commenters refer to treaties

American Indian literature is replete with language that refers to broken or hollow promises the US government has made to American Indians, one of the most prominent being that the US government has not kept its promises regarding health services for American Indians/Alaska Natives (AI/AN). Some commenters refer to treaties between tribes and the US government as the origin of the promise for health services to AI/AN. Others point to the trust relationship between the sovereign nations of American Indian tribes and the US government, while still others assert that the Snyder Act of 1921 or the Indian Health Care Improvement Act (IHCIA) contained the promise for health care. While the US has provided some form of health care for AI/AN since the country was in its infancy, and continues to do so through the Indian Health Service, the promise of health services for AI/AN is not explicit.

Philosophers have articulated that a promise contains a moral obligation to fulfill it because of others’ expectations created by that promise. As the US government made its first promises in early treaties with AI/AN tribes and subsequently made promises in the years since, it is morally obligated to fulfill those promises, be they lying promises or not, because of resulting expectations. Yet, the US government has historically acted to restrict the rights of AI/AN—rights that include access to health services—through assimilation, separation, or termination policies. Further, the policies of the US government have kept the AI/AN populations socioeconomically impoverished, dependent on the US government for basic needs, and susceptible to health-compromising conditions.

Using case studies, this dissertation looks not only at the policies and events that directly affected health services and health status, but also at how those policies and events contributed to health outcomes and the expectations of AI/AN. Given the history of the US government in fulfilling (or not fulfilling) its promises, this dissertation examines the expectations of AI/AN for their own future health outcomes under the policy of self-governance.
ContributorsDrago, Mary (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Committee member) / Herkert, Joseph (Committee member) / Hurlbut, James (Committee member) / Robert, Jason (Committee member) / Trujillo, Michael (Committee member) / Arizona State University (Publisher)
Created2016
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In the fifteen years between the discovery of fetal alcohol syndrome (FAS) in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. I examine how scientific,

In the fifteen years between the discovery of fetal alcohol syndrome (FAS) in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. I examine how scientific, social, moral, and political narratives dynamically interacted to construct the risk of drinking during pregnancy and the public health response of health warning labels on alcohol. To situate such phenomena I first observe the closest regulatory precedents, the public health responses to thalidomide and cigarettes, which established a federal response to fetal risk. I then examine the history of how the US defined and responded to the social problem of alcoholism, paying particular attention to the role of women in that process. Those chapters inform my discussion of how the US reengaged with alcohol control at the federal level in the last quarter of the twentieth century. In the 1970s, FAS allowed federal agencies to carve out disciplinary authority, but robust public health measures were tempered by uncertainty surrounding issues of bureaucratic authority over labeling, and the mechanism and extent of alcohol’s impact on development. A socially conservative presidency, dramatic budgetary cuts, and increased industry funding reshaped the public health approach to alcoholism in the 1980s. The passage of labeling in 1988 required several conditions: a groundswell of other labeling initiatives that normalized the practice; the classification of other high profile, socially unacceptable alcohol-related behaviors such as drunk driving and youth drinking; and the creation of a dual public health population that faced increased medical, social, and political scrutiny, the pregnant woman and her developing fetus.
ContributorsO'Neil, Erica (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / Ellison, Karin (Committee member) / Wetmore, Jameson (Committee member) / Arizona State University (Publisher)
Created2016
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According to traditional Chinese medicine, the month following childbirth is an important period marked by an imbalance of two opposing forces that together make up one’s health and wellbeing. A set of specialized practices called zuoyuezi (sitting the month) aid both the woman’s recovery and restoration of the balance, and

According to traditional Chinese medicine, the month following childbirth is an important period marked by an imbalance of two opposing forces that together make up one’s health and wellbeing. A set of specialized practices called zuoyuezi (sitting the month) aid both the woman’s recovery and restoration of the balance, and require the help of someone else, usually the woman’s mother or mother-in-law. While studies conducted on the practice’s psychosocial and physical benefits have produced varied results, zuoyuezi continues to persist in Hong Kong, China, and Taiwan. Since the late twentieth century, professional zuoyuezi centers have become very popular as a commercial health care business. While the month experiences of Taiwanese and Chinese women have been widely studied, there is little research on physicians’ opinions regarding the practice, especially in Western medical settings. Taiwanese physicians, who have been trained in the Western medical tradition, present interesting case studies as both experts in Western medicine and citizens in traditional Taiwanese society. The purpose of this project is to observe how Taiwanese physicians negotiate primarily cultural practices with their professional training, and whether there is a conflict between physicians’ beliefs about zuoyuezi and physicians’ personal experiences with the practice. Twenty-seven semi-structured interviews of Taiwanese physicians were conducted at two sites in Taiwan regarding their perspective and understanding of zuoyuezi and their personal experiences with it. Following qualitative analysis, the findings showed that physicians used their Western medical training to explain the traditional worldview that holds zuoyuezi. Secondly, physicians acknowledged the benefits of zuoyuezi and the influence of culture as two primary factors in its continued existence. Finally, physicians incorporated zuoyuezi into their personal lives while modifying the traditional practices. Overall, Taiwanese physicians did not appear to have direct conflict with the cultural practice, zuoyuezi, using their medical expertise to rationalize its existence while becoming active participants and co-creators in the practice.
ContributorsChou, Cecilia (Author) / Maienschein, Jane (Thesis advisor) / Gaughan, Monica (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2017